Featured Research

Computer models predict how patients will respond to HIV drugs without the need for resistance testing

Date:

March 14, 2013

Source:

Oxford University Press (OUP)

Summary:

Computer models can predict how HIV patients whose drug therapy is failing will respond to a new treatment. Crucially for patients in poorer countries, the models do not require the results of expensive drug resistance tests to make their predictions. The study also showed that the models were able to identify alternative drug combinations that were predicted to work in cases where the treatment used in the clinic had failed, suggesting that their use could avoid treatment failure.

Share This

Results of a study published online in the Journal of Antimicrobial Chemotherapy March 14, demonstrate that computer models can predict how HIV patients whose drug therapy is failing will respond to a new treatment. Crucially for patients in poorer countries, the models do not require the results of expensive drug resistance tests to make their predictions. The study also showed that the models were able to identify alternative drug combinations that were predicted to work in cases where the treatment used in the clinic had failed, suggesting that their use could avoid treatment failure.

Related Articles

When a patient's HIV drugs begin to fail in well-resourced countries a genotypic resistance test is performed to identify mutations that cause the virus to become resistant to certain drugs. The results are used to predict whether the patient will respond to different drugs in a new treatment. These tests are generally not available in resource-limited settings. Today's study shows that computer models can predict how such a patent will respond, with comparable accuracy, without the need for such tests.

"This is the first time this approach has been tried with real cases of treatment failure from resource-limited settings," commented Julio Montaner, former President of the International AIDS Society, Director of the BC Centre for Excellence in HIV & AIDS, based in Vancouver, Canada and an author on the paper. "The results show that using sophisticated computer based algorithms we can effectively put the experience of treating thousands of patients into the hands of the under-resourced physician with potentially huge benefits."

The models were developed by The HIV Resistance Response Database Initiative (RDI), using information gathered from many thousands of patients in hundreds of clinics around the world. They make their predictions of the probability of the drugs reducing the level of virus below a low limit from the patient's treatment history, the CD4 count(i) and the viral load. The models were most accurate (over 70%) when they were used to make predictions for new cases from the clinics that provided the data used in their training. However they were 60-64% accurate when tested with cases from southern Africa, 57% for India and 67% for Romania where resources are very limited. This compares favourably with accuracy of around 60-65% for genotyping, with interpretation using standard algorithms.

The models were also able to identify alternative, three-drug regimens, comprising locally available drugs that were predicted to produce a virological response for a substantial proportion of the treatment failures observed. This proportion ranged from 75% in Southern Africa, where the number of drugs available was highly restricted, to 93% in Romania and 99% in India. In all cases from the resource-limited countries, the models were able to identify regimens with a higher predicted probability of success than the regimen that failed.

"These results suggest that use of the system could help to avoid significant numbers of treatment failures," commented lead author Andrew Revell of the RDI. "The superiority of the models with cases from 'familiar' settings indicates that the full potential of this system to aid treatment decision-making could be realised by the collection of data from resource-limited settings and the use of these data to train the next generation of models."

It should be noted that, as the study was retrospective, no firm claims can be made for the clinical benefit that use of the system as a treatment support tool could provide. Nevertheless, the results were positive for clinics and cohorts in many different countries across five disparate regions of the world, which is very encouraging in terms of generalizability. The results also suggest that this approach has the potential to reduce virological failure and improve patient outcomes in less well-resourced countries.

[i] CD4 (cluster of differentiation 4) is a glycoprotein found on the surface of immune cells such as T helper cells, monocytes, macrophages, and dendritic cells.

Oxford University Press (OUP). "Computer models predict how patients will respond to HIV drugs without the need for resistance testing." ScienceDaily. ScienceDaily, 14 March 2013. <www.sciencedaily.com/releases/2013/03/130313214015.htm>.

Oxford University Press (OUP). (2013, March 14). Computer models predict how patients will respond to HIV drugs without the need for resistance testing. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2013/03/130313214015.htm

Oxford University Press (OUP). "Computer models predict how patients will respond to HIV drugs without the need for resistance testing." ScienceDaily. www.sciencedaily.com/releases/2013/03/130313214015.htm (accessed March 31, 2015).

Mar. 31, 2015  Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and ... full story

Mar. 31, 2015  Alcoholism takes a toll on every aspect of a person's life, including skin problems. Now, a new research report helps explain why this happens and what might be done to address it. "The clinical ... full story

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Mar. 31, 2015  A drug being developed to treat osteoporosis may also be useful for treating osteogenesis imperfecta or brittle bone disease, a rare but potentially debilitating bone disorder that that is present ... full story

Mar. 31, 2015  It is possible to quantify and classify the effects of different diseases on the activity of intestinal bacteria, new research demonstrates for the first time. Human intestinal flora, known as ... full story

Mar. 31, 2015  During prenatal development, the brains of most animals, including humans, develop specifically male or female characteristics. But scientists have known little about the details of how this ... full story

Mar. 31, 2015  A history of depression may put women at risk for developing diabetes during pregnancy, according to research. This study also pointed to how common depression is during pregnancy and the need for ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Related Stories

May 22, 2014  74 percent of HIV-positive children in a study developed resistance to at least one form of drug treatment. The researchers followed almost 450 children enrolled in the Pediatric HIV/AIDS Cohort ... full story

Nov. 25, 2013  New computer models predict how patients whose HIV therapy is failing will respond to any new combination of drugs, without the need for an HIV genotype: a test used in wealthy countries to read the ... full story

July 8, 2011  Protease inhibitor drugs are one of the major weapons in the fight against HIV, the virus that causes AIDS, but their effectiveness is limited as the virus mutates and develops resistance to the ... full story

Dec. 15, 2010  Microbiologists and biochemists reveal new findings that shed light on how HIV eludes treatment by mutating. His discoveries provide clues into HIV's mechanisms for resisting two main families ... full story

Oct. 6, 2010  HIV-TRePS is a new system that predicts how an HIV patient will respond to different drug regimens, with an accuracy of around 80%. It is free to use, accessed over the Internet, and helps physicians ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.